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3 Cocaine Cocaine works as a stimulant. Many cocaine users are able to fit cocaine into their lives without developing problems; they use cocaine for recreational purposes. However, the drug can lead to addiction. Cocaine can be used in a variety of forms (Boekhout van Solinge, 2001). In powder form, (cocaine hydrochloride) cocaine is usually snorted in the Netherlands, and rarely injected. Occasionally it is smoked like a cigarette. Street names for this kind of cocaine include ‘coke’, ‘flake’, ‘candy’, ‘nose candy’ ‘o.k.’, ‘okey doke’, ‘AKA’, ‘Vitamin C’, ‘white lady’ and ‘coca puffs’. Among problem hard drug users, the base form of cocaine (‘crack cocaine’) is the most popular. Base cocaine is obtained by heating a solution of cocaine powder and a base substance, such as natrium bicarbonate or ammonia. It is smoked in a little pipe or tube or inhaled from aluminium foil. Both methods are known in this study as smoking, unless stated otherwise. Crack owes its name to the crackling sound it emits during the heating process. In the 1980s the users made their own base cocaine. Nowadays it is sold ready for use on the streets. The data below apply to all forms of cocaine, unless stated otherwise. 3.1 Recent facts and trends The main facts and trends concerning cocaine in this chapter are: • In the school-going population aged 12-18 in mainstream education, ever use of cocaine declined slightly between 1996 and 2007. Current use remained stable (§ 3.2). • Pupils attending REC-4 schools who are receiving special education more often use cocaine than their peers in mainstream schools and other forms of special education (§ 3.2). • After ecstasy, cocaine is the most popular hard drug among juveniles and young adults in the social scene (§ 3.2). • With regard to recent use of cocaine, the Dutch score below average compared to other European member states (§ 3.5). • The slight drop between 2004 and 2006 in the total number of clients seeking treatment from addiction care for cocaine use did not continue into 2007; however there was a further slight decline in 2008. There is a difference in trends for clients with a primary snorting problem (increase) and those with a primary crack problem (decrease) (§ 3.6). • Cocaine use features strongly in drug-related accidents in hospital emergency departments (§ 3.6). 3 Cocaine 59
• Between 2007 and 2008, there was little change in the number of clinical admissions to general hospitals on account of cocaine misuse and dependency. However, a longer term view shows a rise (§ 3.6). • The number of registered acute deaths from cocaine use is low, and remained stable between 2004 and 2008 (§ 3.7). • In recent years, powder cocaine used by consumers has been relatively often found to be mixed with medicines. There has been a marked rise in the use of levamisol as a mixing agent (§ 3.8). 3.2 Usage: general population • Between 2001 and 2005 there was an increase in the number of people in the Netherlands aged between 15 and 64 who had experience with cocaine (table 3.1). The difference between 1997 and 2001 was not significant (Rodenburg et al., 2007). • The percentage of recent and current users remained at the same level in all three surveys. The percentage of current users was the same in the 1997 and 2005 surveys. The decline recorded in 2001 was not significant. • In absolute figures, there were an estimated 32 thousand current users of cocaine in the Netherlands in 2005. These figures are virtually certain to be an underestimation, because problem users of hard drugs are under-represented in population surveys, such as the NPO. • The annual increase in first-time users of cocaine dropped from 0.4% in 2001 to 0.1% in 2005. These figures could be indicative of a decline in the new use of cocaine. Table 3.1 Cocaine use in the Netherlands in the population aged 15 to 64. Survey years 1997, 2001 and 2005 1997 2001 2005 Ever use 2.6% 2.1% 3.4% Recent use I 0.7% 0.7% 0.6% Current use II 0.3% 0.1% 0.3% Used for the first time in the past year 0.3% 0.4% 0.1% Average age of the recent users I 27.7 26.7 31.9 Number of respondents: 17 590 (1997), 2 312 (2001), 4 516 (2005). I. In the past year. II. In the past month. Source: NPO, IVO. 60 Netherlands National Drug Monitor - NDM Annual Report 2009
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Netherlands National Drug Monitor N
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Colophon Project Manager Dr. M.W. v
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Preface This is already the tenth A
Page 9 and 10: 5.4 Problem Use 113 5.5 Usage: Inte
Page 12 and 13: List of abreviations and acronyms 2
Page 14 and 15: NEMESIS NFU NIGZ NMG NPO NRI NVIC N
Page 16 and 17: Summary Below is an outline of the
Page 18 and 19: The number of hospital admissions c
Page 20 and 21: GHB. In 2008/2009 4.6 percent of fr
Page 22 and 23: Deaths In the Netherlands, smoking
Page 24 and 25: Offences by drug users Drug users c
Page 26 and 27: Opiates Ecstasy Amphetamine Alcohol
Page 28 and 29: 1 Introduction The National Drug Mo
Page 30 and 31: use, particularly cannabis, under-r
Page 32 and 33: information is available, this is b
Page 34 and 35: 2 Cannabis Cannabis (Cannabis Sativ
Page 36 and 37: Figure 2.1 Cannabis users in the Ne
Page 38 and 39: Figure 2.2 Cannabis use among secon
Page 40 and 41: Cannabis and problem behaviour •
Page 42 and 43: Table 2.4 Cannabis use among pupils
Page 44 and 45: Table 2.5 Current cannabis use in s
Page 46 and 47: • The sharp increase in treatment
Page 48 and 49: Trends It is difficult to determine
Page 50 and 51: • The role of cannabis in all req
Page 52 and 53: - misuse or dependence on alcohol a
Page 54 and 55: At the Ambulance Transport Centre (
Page 56 and 57: • So far, epidemiological studies
Page 58 and 59: Quality and price The Trimbos Insti
Page 62 and 63: Age, gender and urbanisation level
Page 64 and 65: Special groups In certain groups of
Page 66 and 67: Table 3.3 Cocaine use in special gr
Page 68 and 69: and 7.7% in the U.K (England and Wa
Page 70 and 71: Table 3.5 Cocaine use among school-
Page 72 and 73: Figure 3.2 Number of (outpatient) a
Page 74 and 75: Figure 3.4 Admissions to general ho
Page 76 and 77: The Netherlands Cause-of-Death stat
Page 78: • Little is known as yet about a
Page 81 and 82: 4.2 Usage: general population Heroi
Page 83 and 84: • In the province of Gelderland,
Page 85 and 86: Figure 4.1 Estimates of the number
Page 87 and 88: and syringes exchanged has been reg
Page 89 and 90: • Between 2001 and 2004 the numbe
Page 91 and 92: - misuse of or dependence on alcoho
Page 93 and 94: same time it should be noted that t
Page 95 and 96: International comparison The Europe
Page 97 and 98: The total number of chronic hepatit
Page 99 and 100: • It is thought that risk behavio
Page 101 and 102: the ICD-9 classification. Drug deat
Page 103 and 104: Amsterdam GGD Amsterdam reports the
Page 105 and 106: Figure 4.9 Number of drug-induced d
Page 107 and 108: • Pupils attending REC-4 schools
Page 109 and 110: 5.3 Usage: juveniles and young adul
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• In 2008, key observers in Amste
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Table 5.3 Use of Ecstasy and amphet
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Table 5.4a Use of amphetamines and
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Table 5.5a Ecstasy use among school
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Ecstasy • The number of (outpatie
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Figure 5.3 Numbers registered with
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• The same person may be admitted
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• The number of requests for info
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According to the EMCDDA, in other E
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Figure 5.6 Concentration of MDMA in
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Table 5.9 Number of samples contain
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• Consumers who had drug samples
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6.2 Usage: general population The r
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GHB use is more common among juveni
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• GHB use among school-goers is l
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Table 6.4 GHB incidents registered
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• Of the liquid samples sold as G
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• Total deaths from alcohol-relat
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Figure 7.1 Alcohol consumption amon
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Ethnic background • Among seconda
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Table 7.3 Percentage of current dri
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Table 7.4 Alcohol use in the social
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Holiday-makers • Research conduct
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Figure 7.3 Heavy drinkers by gender
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The countries with the lowest perce
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• In France it is more likely tha
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Figure 7.6 Age distribution of prim
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• In 2008, 337 day-care admission
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• In approximately 1,200 admissio
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Table 7.9 Estimated number of injur
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• On the basis of current researc
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Figure 7.10 Deaths from alcohol use
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• EU member states have different
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• Surveys by the Continuous Surve
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Figure 8.1 Percentage of smokers in
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8.3 Usage: juveniles and young adul
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Special education Table 8.3 shows t
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Table 8.4 Smokers in the EU-15 plus
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medication, Champix ® , which was
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among passive smoking men, the elev
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Table 8.6 Deaths from lung cancer a
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Since 1 January 2003 it is no longe
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Table 8.8 Cigarette prices and taxe
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eported. These refer to 2007 in the
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Table 9.1 Criminal investigations i
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Table 9.2 Number of dismantled prod
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Table 9.3 Characteristics of suspec
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Figure 9.2 Number of Opium Act case
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Table 9.5 Opium Act cases as a perc
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Disposals by the courts (in the fir
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• Financial orders (Public Prosec
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Table 9.9 Prevalence of new crimina
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10.2 Drug use among offenders Drug-
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• In some two-thirds of cases opi
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I, II Table 10.2 Number of times th
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• The ISD has a capacity of 1,000
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• Although there are some female
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Clinical admission Admission to a h
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Mellow Type of music at raves that
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Secondary diagnosis A secondary or
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Dismissal on policy grounds Decisio
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eintegration and rehabilitation of
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I. Use and problem use Source Targe
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II. Treatment demand and treatment
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IV. Market information Source Targe
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Source Target group/subject Sources
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Appendix C Explanation of ICD-9 and
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Appendix D Websites in the area of
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Ministry for Health, Welfare and Sp
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Appendix E Drug use in a number of
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References Adlaf, E.M., Korf, D.J.,
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Coumans, A.M. (2005). Survival on t
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Ganpat, S., Wits, E., Schoenmakers,
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Knibbe, R.A., Joosten, J., Derickx,
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Monshouwer, K., Smit, F., De Graaf,
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Rigter, H., Van Laar, M. (2002). Ep
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Tweede Kamer der Staten-Generaal (2
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Van Leeuwen, F.E. (1999). Epidemiol
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In the Netherlands various monitori
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